Clinical meaning
Hyperemesis gravidarum is a severe form of morning sickness characterized by persistent, intractable nausea and vomiting during pregnancy that leads to significant weight loss (>5% of pre-pregnancy weight), dehydration, electrolyte imbalances, and ketonuria. It is thought to be caused by rapidly rising levels of human chorionic gonadotropin (hCG), estrogen, and progesterone. Unlike normal morning sickness which resolves by 12-14 weeks, hyperemesis can persist throughout pregnancy. The nurse monitors vital signs, intake and output, and dietary tolerance, reporting changes to the nursing team.
Exam relevance
Risk factors: - First pregnancy (primiparous) - Multiple gestation (higher hCG levels) - Molar pregnancy (hydatidiform mole) - History of hyperemesis in previous pregnancy - History of motion sickness or migraines - Family history of hyperemesis gravidarum - Obesity - Hyperthyroidism
Diagnostics: - Monitor vital signs for tachycardia and hypotension indicating dehydration - Record strict intake and output - Monitor daily weights and report significant weight loss - Report inability to tolerate oral fluids for more than 24 hours - Observe for signs of dehydration: dry mucous membranes, poor skin turgor, concentrated urine - Report ketone odor on breath